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As we mentioned last week, your children should not be complaining of foot pain. If they are you should take them seriously and contact your local Podiatrist for evaluation as soon as possible. Foot pain in children is hardly normal. Sever’s Disease (Calcaneal Apophysitis) is localized to the heel and is the most common cause of heel pain in children, seen in individuals 10-14 years of age. If your child is suffering from Sever’s Disease, they will complain of pain in the heel, difficulty partaking in athletic activities and they may even begin to walk with a limp. These should signal red flags to you that there is injury present and immediate evaluation becomes important!

Sever’s Disease is described as a painful inflammation of the growth plate within your child’s heel. Unlike the other bones in the foot, the heel has two “centers of ossification,” or areas where the heel bone grows from. As your child ages, those two areas of growth meet one another, creating one heel bone and solidifying completely by the age of 14. With two areas of growth, any abnormal forces or repetitive injury to the heel can slow the process of their coming together and create inflammation in that area, leading to the diagnosis of Sever’s Disease.

Inflammation of the growth plate is commonly seen in children who are involved in athletic activities. Due to the repetitive trauma placed on to the heel bone with running, jumping and pounding on unforgiving surfaces such as blacktop, inflammation can easily find its way to the area in and around the heel. The muscles being used to support both the heel and the foot place undue stress on the two areas of the heel bone; combined with the inflammation, pain results! Children involved in activities such as soccer, basketball and track are the most vulnerable. With that said, fear of Sever’s Disease is no reason to keep your children from engaging in activities. Let them have fun and be kids! There is a small percentage of individuals that suffer from this injury, and it is can easily be corrected so that your child will not suffer any long-term difficulties. Other things that may lead to Sever’s Disease, but less commonly so than repetitive trauma include obesity, congenital structural problems in your child’s foot and tight musculature surrounding the heel bone.

Once your child has been diagnosed with Sever’s Disease, it is first important to remember that although it is a “disease,” Sever’s is free from systemic (whole body) effects, and is treatable and curable. Your Podiatrist is likely to suggest a reduction in activity by your child and possibly immobilization with a cast that may be removable or non-removable, depending on Doctor’s preference. Both of these treatment methods attempt to reduce stresses on the heel and allow the body to decrease inflammation in the area, while giving the heel time to grow without abnormal forces from activity or musculature pull. It is possible that they will suggest your child take over the counter anti-inflammatory medications to help the healing process by decreasing inflammation as well as decrease the level of pain your child is experiencing. Finally, in more complicated or painful cases, your Podiatrist may recommend your child undergo several weeks of Physical Therapy. The goal of therapy is to increase flexibility in the musculature surrounding and attaching to the heel, helping to decrease any abnormal forces those muscles may be exerting.

It may be difficult to prevent Sever’s Disease, but certainly wearing comfortable athletic shoes that are also supportive may help. It is good to keep in mind that your child is young and things are still growing. Certainly you should not withhold them from activities they love, but encourage them regardless of their abilities, rather than pushing them to the limit and creating undue stress on the heel, or any parts of their fragile bodies for that matter!